Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.013
Z. Mu, S. Xiu, Li Wang
Objective To study the relationship between vitamin D level and muscle mass and grip strength in elderly patients with type 2 diabetes mellitus (T2DM). Methods From May 2016 to January 2018, 201 patients with type 2 diabetes mellitus aged ≥ 60 who were admitted to the Department of endocrinology of Xuanwu Hospital were selected for prospective study. According to 25-hydroxyvitamin D level(25(OH)D), the patients were divided into the vitamin D deficiency group (25(OH)D<20 μg/L, 140 cases) and the non-deficiency group (20 μg/L≤25(OH)D<70 μg/L, 61 cases). The grip strength, walking speed and muscle mass of upper and lower limbs were measured.Physical examination and laboratory examination were carried out. Results There was no significant difference between the two groups (P>0.05). The grip strength, upper limb and lower limb muscle contents in the non deficiency group were significantly higher than those in the deficiency group ((33.49±9.43) kg vs.(29.59±10.30) kg, (4.99±1.09) kg vs.(4.57±1.11) kg, (15.69±3.10) kg vs.(14.54±3.03) kg, P=0.01, 0.015, 0.017). Multivariate logistic regression analysis showed that vitamin D deficiency was independently related to grip strength and lower limb muscle mass(OR=1.286, 95% CI: 1.197-1.346, P<0.01; OR=1.231, 95%CI: 1.102-1.283, P<0.05). Conclusion Vitamin D deficiency is a risk factor for the decrease of grip strength and lower extremity muscle mass in elderly patients with type 2 diabetes. Key words: Type 2 diabetes; Vitamin D; Grip; Muscle mass
{"title":"Study on the relationship between vitamin D, grip strength and muscle mass in elderly diabetic patients","authors":"Z. Mu, S. Xiu, Li Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.013","url":null,"abstract":"Objective \u0000To study the relationship between vitamin D level and muscle mass and grip strength in elderly patients with type 2 diabetes mellitus (T2DM). \u0000 \u0000 \u0000Methods \u0000From May 2016 to January 2018, 201 patients with type 2 diabetes mellitus aged ≥ 60 who were admitted to the Department of endocrinology of Xuanwu Hospital were selected for prospective study. According to 25-hydroxyvitamin D level(25(OH)D), the patients were divided into the vitamin D deficiency group (25(OH)D<20 μg/L, 140 cases) and the non-deficiency group (20 μg/L≤25(OH)D<70 μg/L, 61 cases). The grip strength, walking speed and muscle mass of upper and lower limbs were measured.Physical examination and laboratory examination were carried out. \u0000 \u0000 \u0000Results \u0000There was no significant difference between the two groups (P>0.05). The grip strength, upper limb and lower limb muscle contents in the non deficiency group were significantly higher than those in the deficiency group ((33.49±9.43) kg vs.(29.59±10.30) kg, (4.99±1.09) kg vs.(4.57±1.11) kg, (15.69±3.10) kg vs.(14.54±3.03) kg, P=0.01, 0.015, 0.017). Multivariate logistic regression analysis showed that vitamin D deficiency was independently related to grip strength and lower limb muscle mass(OR=1.286, 95% CI: 1.197-1.346, P<0.01; OR=1.231, 95%CI: 1.102-1.283, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000Vitamin D deficiency is a risk factor for the decrease of grip strength and lower extremity muscle mass in elderly patients with type 2 diabetes. \u0000 \u0000 \u0000Key words: \u0000Type 2 diabetes; Vitamin D; Grip; Muscle mass","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49623725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.011
Lei Zhou
Objective To investigate the clinical value of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)and Left ventricular mass index(LVMI )in evaluating the prognosis of elderly heart failure patients with preserved ejection fraction (HFpEF). Methods From January 2018 to December 2018, 170 patients with heart failure (age≥65years old) in the Third Affiliated Hospital of Anhui Medical University were selected as the subjects of prospective study.According to the left ventricular ejection fraction (LVEF), the patients were divided into two groups: the heart failure with preserved ejection fraction (HFpEF) group (100 cases), the heart failure with reduced ejection fraction (HFrEF) group (70 cases), and the healthy subjects (58 cases) as the control group.Left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end diastolic diameter (LVEDD), LVEF, left ventricular mass index (LVMI) and plasma NT-proBNP concentrations were compared among the three groups.The study group was followed up for 6 months after standardized treatment to observe the occurrence of major cardiovascular adverse events (MACE). Multiple logistic regression was used to analyze the correlation between the above indexes and the occurrence of mace.ROC curve was used to analyze the predictive value of NT proBNP and LVMI. Results There were significant differences in LAD, IVSTt, LVPWT, LVEDD, LVEF and LVMI among each group (F value was 110.878, 75.838, 74.044, 137.985, 495.267 and 122.810, respectively, all P<0.001 ). The LAD, IVST, LVPWT, LVEDD, and LVMI in the HFpEF group((40.81 ±4.46) mm, (9.39±1.15) mm, (9.68±1.11) mm, (55.54±3.67) mm, (125.45±19.17) g/m2) were higher than those in the control group ((32.9±3.20) mm, (7.62±0.64) mm, (7.81±0.58) mm, (47.05±3.13) mm, (77.72±11.79) g/m2), and the LVEF was lower than that of the control group ((59.63±5.23)% vs.(67.7±4.35)%) with statistical significance (all P<0.05). IVST, LVPWT, LVEF in HFpEF group( (9.39±1.15) mm, (9.68±1.11) mm, (9.63±5.23)%) were higher than those in HFrEF group ((7.59±1.28) mm, (8.01±1.39) mm, (36.9±7.63 )%) ; and the LAD, LVEDD in HFpEF group ((40.81±4.46) mm, (55.54±3.67) mm) were lower than those in HFrEF group ((45.51±6.1) mm, (64.77±9.55) mm), and the differences were statistically significant (all P<0.05). The plasma NT-proBNP concentration was the lowest in the control group, followed by the HFpEF group and the highest in the HFrEF group(56.0 (30.0, 78.56), 2 624.5 (1 190.5, 5 558.5), 8 528.5 (2 651.0, 21 582.75), F=81.355, P<0.01). Multivariant Logistic regression analysis showed that NT-proBNP and LVMI were independent risk factors for occurrence of MACE in patients with HFpEF(OR=4.796, 95%CI: 2.348-5.127, P=0.035; OR=1.957, 95%CI: 1.810-3.327, P=0.016). ROC curve analysis showed that the area under the curve of cardiovascular adverse events predicted by NT-proBNP and LVMI for 6 months was 0.888(95%CI: 0.825-0
{"title":"Study on the relationship between Plasma Pro amino terminal brain natriuretic peptide, left ventricular mass index and the prognosis in elderly heart failure patients with preserved ejection fraction","authors":"Lei Zhou","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.011","url":null,"abstract":"Objective \u0000To investigate the clinical value of plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)and Left ventricular mass index(LVMI )in evaluating the prognosis of elderly heart failure patients with preserved ejection fraction (HFpEF). \u0000 \u0000 \u0000Methods \u0000From January 2018 to December 2018, 170 patients with heart failure (age≥65years old) in the Third Affiliated Hospital of Anhui Medical University were selected as the subjects of prospective study.According to the left ventricular ejection fraction (LVEF), the patients were divided into two groups: the heart failure with preserved ejection fraction (HFpEF) group (100 cases), the heart failure with reduced ejection fraction (HFrEF) group (70 cases), and the healthy subjects (58 cases) as the control group.Left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end diastolic diameter (LVEDD), LVEF, left ventricular mass index (LVMI) and plasma NT-proBNP concentrations were compared among the three groups.The study group was followed up for 6 months after standardized treatment to observe the occurrence of major cardiovascular adverse events (MACE). Multiple logistic regression was used to analyze the correlation between the above indexes and the occurrence of mace.ROC curve was used to analyze the predictive value of NT proBNP and LVMI. \u0000 \u0000 \u0000Results \u0000There were significant differences in LAD, IVSTt, LVPWT, LVEDD, LVEF and LVMI among each group (F value was 110.878, 75.838, 74.044, 137.985, 495.267 and 122.810, respectively, all P<0.001 ). The LAD, IVST, LVPWT, LVEDD, and LVMI in the HFpEF group((40.81 ±4.46) mm, (9.39±1.15) mm, (9.68±1.11) mm, (55.54±3.67) mm, (125.45±19.17) g/m2) were higher than those in the control group ((32.9±3.20) mm, (7.62±0.64) mm, (7.81±0.58) mm, (47.05±3.13) mm, (77.72±11.79) g/m2), and the LVEF was lower than that of the control group ((59.63±5.23)% vs.(67.7±4.35)%) with statistical significance (all P<0.05). IVST, LVPWT, LVEF in HFpEF group( (9.39±1.15) mm, (9.68±1.11) mm, (9.63±5.23)%) were higher than those in HFrEF group ((7.59±1.28) mm, (8.01±1.39) mm, (36.9±7.63 )%) ; and the LAD, LVEDD in HFpEF group ((40.81±4.46) mm, (55.54±3.67) mm) were lower than those in HFrEF group ((45.51±6.1) mm, (64.77±9.55) mm), and the differences were statistically significant (all P<0.05). The plasma NT-proBNP concentration was the lowest in the control group, followed by the HFpEF group and the highest in the HFrEF group(56.0 (30.0, 78.56), 2 624.5 (1 190.5, 5 558.5), 8 528.5 (2 651.0, 21 582.75), F=81.355, P<0.01). Multivariant Logistic regression analysis showed that NT-proBNP and LVMI were independent risk factors for occurrence of MACE in patients with HFpEF(OR=4.796, 95%CI: 2.348-5.127, P=0.035; OR=1.957, 95%CI: 1.810-3.327, P=0.016). ROC curve analysis showed that the area under the curve of cardiovascular adverse events predicted by NT-proBNP and LVMI for 6 months was 0.888(95%CI: 0.825-0","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42438795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.002
Weina Chen, Yantao Wang, W. Di, B. Kong
Objective To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy. Methods From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups: 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS). Results After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS (HR(95%CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS (HR(95%CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant (P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant(P= 0.026). Conclusion The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected
{"title":"Analysis of the factors influencing the pathological complete remission and prognosis of young breast cancer patients after neoadjuvant chemotherapy","authors":"Weina Chen, Yantao Wang, W. Di, B. Kong","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.002","url":null,"abstract":"Objective \u0000To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy. \u0000 \u0000 \u0000Methods \u0000From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups: 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS). \u0000 \u0000 \u0000Results \u0000After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS (HR(95%CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS (HR(95%CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant (P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant(P= 0.026). \u0000 \u0000 \u0000Conclusion \u0000The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected ","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48656345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.014
Zeng-sheng Wang, Yan Li, Tao Lang, Xiao-yan Zhang, L. Fu, H. Ai, Xiaoming Wang
Objective To investigate the expression levels of CD4+ CD25+ FOXP3+ Treg cells and interleukin(IL)-10 in serum of patients with myelodysplastic syndrome (MDS) - refractory anemia (RA) and refractory hematopenia with multilineage dysplasia (RCMD), and to evaluate the effect of cyclosporine on CD4+ CD25+ FOXP3+ Treg cells in MDS patients. Methods From January 2016 to January 2018, 25 MDS-RA and RCMD patients and 13 healthy controls were selected from people′s Hospital of Xinjiang Uygur Autonomous Region for retrospective analysis.The expression of CD4 + CD25 + Foxp3 + Treg and IL-10 in peripheral blood samples were detected by flow cytometry and enzyme-linked immunosorbent assay.The expression of CD4 + CD25 + Foxp3 + Treg and IL-10 in MDS-RA and RCMD patients before and 6 months after the treatment with CSA based immunosuppressive regimen was detected. Results Of the 25 patients, 13 (52%) were effective and 12 (48%) were ineffective.The proportion of CD4 + CD25 + Foxp3 + Treg in CD4 + T cells of MDS group was significantly higher than that of healthy control group [(0.37 ± 0.10)% and (0.12 ± 0.06)% respectively, t= 2.02, P< 0.001]. The level of IL 10 in MDS group was significantly higher than that in healthy control group ((7.16±1.27) μg /L and (2.75 ± 1.06) μg /L, t= 2.03, P< 0.001). The ratio of CD4 + CD25 + Foxp3 + Treg cells in MDS group was lower than that in MDS Group ((0.15±0.06)% and (0.26±0.08%), t= 1.71, P< 0.001), and the level of IL 10 in MDS group was lower than that in MDS Group ((3.22±1.01) μg /L and (4.25±1.22) μg /L, t= 2.06, P= 0.030). The proportion of CD4 + CD25 + Foxp3 + Treg in peripheral blood of 25 MDS patients was positively correlated with the level of IL-10 expression (r= 0.35, P= 0.02). Conclusion The expression of CD4+ CD25+ FOXP3+ Treg cells and IL-10 increased in MDS patients increased, but decreased after cyclosporine treatment. Key words: Myelodysplastic syndrome; CD4+ CD25+ FOXP3+ Treg cells; Interleukin 10
{"title":"Characteristics of CD4+ CD25+ FoxP3+ Treg cells in patients with myelodysplastic syndrome and the effect of cyclosporine","authors":"Zeng-sheng Wang, Yan Li, Tao Lang, Xiao-yan Zhang, L. Fu, H. Ai, Xiaoming Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.014","url":null,"abstract":"Objective \u0000To investigate the expression levels of CD4+ CD25+ FOXP3+ Treg cells and interleukin(IL)-10 in serum of patients with myelodysplastic syndrome (MDS) - refractory anemia (RA) and refractory hematopenia with multilineage dysplasia (RCMD), and to evaluate the effect of cyclosporine on CD4+ CD25+ FOXP3+ Treg cells in MDS patients. \u0000 \u0000 \u0000Methods \u0000From January 2016 to January 2018, 25 MDS-RA and RCMD patients and 13 healthy controls were selected from people′s Hospital of Xinjiang Uygur Autonomous Region for retrospective analysis.The expression of CD4 + CD25 + Foxp3 + Treg and IL-10 in peripheral blood samples were detected by flow cytometry and enzyme-linked immunosorbent assay.The expression of CD4 + CD25 + Foxp3 + Treg and IL-10 in MDS-RA and RCMD patients before and 6 months after the treatment with CSA based immunosuppressive regimen was detected. \u0000 \u0000 \u0000Results \u0000Of the 25 patients, 13 (52%) were effective and 12 (48%) were ineffective.The proportion of CD4 + CD25 + Foxp3 + Treg in CD4 + T cells of MDS group was significantly higher than that of healthy control group [(0.37 ± 0.10)% and (0.12 ± 0.06)% respectively, t= 2.02, P< 0.001]. The level of IL 10 in MDS group was significantly higher than that in healthy control group ((7.16±1.27) μg /L and (2.75 ± 1.06) μg /L, t= 2.03, P< 0.001). The ratio of CD4 + CD25 + Foxp3 + Treg cells in MDS group was lower than that in MDS Group ((0.15±0.06)% and (0.26±0.08%), t= 1.71, P< 0.001), and the level of IL 10 in MDS group was lower than that in MDS Group ((3.22±1.01) μg /L and (4.25±1.22) μg /L, t= 2.06, P= 0.030). The proportion of CD4 + CD25 + Foxp3 + Treg in peripheral blood of 25 MDS patients was positively correlated with the level of IL-10 expression (r= 0.35, P= 0.02). \u0000 \u0000 \u0000Conclusion \u0000The expression of CD4+ CD25+ FOXP3+ Treg cells and IL-10 increased in MDS patients increased, but decreased after cyclosporine treatment. \u0000 \u0000 \u0000Key words: \u0000Myelodysplastic syndrome; CD4+ CD25+ FOXP3+ Treg cells; Interleukin 10","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49020516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.003
Zhi-ping Guo
Objective To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC). Methods From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC). Results There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group(F values were 56.832, 38.209, 23.415, respectively; χ2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). Conclusion Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis. Key words: Primary hepatic cancer; Lipid carrier protein; Alpha fetoprotein; Leucine aminopeptidase; α-L-Fucosidase; Diagnosis
{"title":"Diagnostic value of alpha fetoprotein, leucine aminopeptidase and α L fucosidase in primary liver cancer","authors":"Zhi-ping Guo","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.003","url":null,"abstract":"Objective \u0000To investigate the detection of neutrophil gelatinase related lipid carrier protein (NGAL), alpha fetoprotein (AFP), leucine aminopeptidase (LAP), alpha L fucosidase (AFU) in primary liver cancer (PHC) individually and jointly The diagnostic value of cancer (PHC). \u0000 \u0000 \u0000Methods \u0000From January 2015 to December 2017, 124 patients with primary liver cancer from the third people′s Hospital of Yunnan Province were selected as PHC group, 53 patients with cirrhosis treated at the same time as benign group A, 37 patients with liver cyst as benign group B, and 64 healthy volunteers as healthy group. The serum AFU, LAP, NGAL and AFP of four groups of subjects were detected by rate method, immunoturbidimetric method and electrochemiluminescence method respectively. The diagnostic efficacy of PHC detected by different combinations of indicators was analyzed by receiver operating characteristic curve (ROC). \u0000 \u0000 \u0000Results \u0000There were significant differences in serum AFP, AFU, LAP levels and positive expression rates between PHC group, benign group A, group B and healthy group(F values were 56.832, 38.209, 23.415, respectively; χ2 values were 69.324, 72.568, 24.695, respectively; all P<0.05), and the serum AFP, AFU, LAP levels and positive expression rate were significantly higher in the PHC group than in the benign group A, group B and healthy group, the difference was statistically significant( all P<0.05); sensitivity of AFP+ AFU+ LAP combined detection(89.27% vs.72.17%, 73.52%, 76.31%, 81.35%, 80.69%, 86.87%), specificity(95.76% vs.81.58%, 82.79%, 84.16%, 86.95%, 94.23%, 93.29%) and the Yoden index (0.85 and 0.54, 0.56, 0.60, 0.68, 0.75, 0.80) are superior to their one indicator (LAP, AFU, AFP) and two indexes combined detection(LAP+ AFU, LAP+ AFP, AFU+ AFP). ROC curve analysis showed that the AUC(0.94) combined with AFP+ AFU+ LAP was greater than LAP+ AFU(0.78), LAP+ AFP(0.85) and AFU+ AFP(0.89). \u0000 \u0000 \u0000Conclusion \u0000Combined detection of AFP, AFU and LAP can effectively improve the diagnosis efficiency of PHC and reduce missed diagnosis. \u0000 \u0000 \u0000Key words: \u0000Primary hepatic cancer; Lipid carrier protein; Alpha fetoprotein; Leucine aminopeptidase; α-L-Fucosidase; Diagnosis","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48163815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.008
Q. Zhu, Qi Sun
Objective To explore the efficacy and safety of the remedial stent implantation after mechanical thrombectomy for acute cerebral infarction. Methods From October 2014 to December 2018, the clinical data of 16 patients with acute cerebral infarction who could not maintain forward blood flow after mechanical thrombectomy in 985 Hospital of joint service support force of PLA were analyzed retrospectively.To analyze the score of National Institutes of Health Stroke Scale (NIHSS), degree of vascular recanalization after operation thrombolysis incerebral infarction(TICI) classificatio, mechanical thrombolytic number, postoperative vascular reocclusion rate, incidence of intracranial hemorrhage, NIHSS score 1 week later, good clinical result after 90 days(improved Rankin scale, mRs= 0-2) and other indicators. Results After mechanical embolectomy, 16 stents were implanted (15 of them were Solitaire stents, 1 of them was Apollo stents), 12 patients with TICI=3, and 4 patients with TICI=2b.The average number of times of mechanical thrombectomy was(3.25±1.09). Balloon expansion was performed before stent placement in 7 patients with limited stenosis.The time from the onset to the reperfusion was(10.96 ± 3.24) hours. Computed tomography angiography(CTA) was reexamined 24 hours after operation, showing vascular of 3 cases were reocclusion and 3 cases occured intracranial hemorrhage(all less than 10 ml). In 2 cases of decompressive osteotomy, NIHSS score was improved from preoperative (24.25±4.58) points to postoperative (7.44±5.09) points.After 90 days, 10 patients had a good prognosis (mRs ≤ 2) and 1 patient died (pulmonary infection). Conclusion After mechanical thrombectomy of acute cerebral infarction, if there is severe stenosis or forward blood flow can not be maintained, use the Solitaire stent or other stent to remedy the placement, with fewer complications and better clinical effect. Key words: Acute ischemic stroke; Stent implantation; Remedial treatment; Mechanical thrombectomy
{"title":"Clinical analysis of 16 cases of remedial stent placement after mechanical thrombectomy for acute cerebral infarction","authors":"Q. Zhu, Qi Sun","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.008","url":null,"abstract":"Objective To explore the efficacy and safety of the remedial stent implantation after mechanical thrombectomy for acute cerebral infarction. Methods From October 2014 to December 2018, the clinical data of 16 patients with acute cerebral infarction who could not maintain forward blood flow after mechanical thrombectomy in 985 Hospital of joint service support force of PLA were analyzed retrospectively.To analyze the score of National Institutes of Health Stroke Scale (NIHSS), degree of vascular recanalization after operation thrombolysis incerebral infarction(TICI) classificatio, mechanical thrombolytic number, postoperative vascular reocclusion rate, incidence of intracranial hemorrhage, NIHSS score 1 week later, good clinical result after 90 days(improved Rankin scale, mRs= 0-2) and other indicators. Results After mechanical embolectomy, 16 stents were implanted (15 of them were Solitaire stents, 1 of them was Apollo stents), 12 patients with TICI=3, and 4 patients with TICI=2b.The average number of times of mechanical thrombectomy was(3.25±1.09). Balloon expansion was performed before stent placement in 7 patients with limited stenosis.The time from the onset to the reperfusion was(10.96 ± 3.24) hours. Computed tomography angiography(CTA) was reexamined 24 hours after operation, showing vascular of 3 cases were reocclusion and 3 cases occured intracranial hemorrhage(all less than 10 ml). In 2 cases of decompressive osteotomy, NIHSS score was improved from preoperative (24.25±4.58) points to postoperative (7.44±5.09) points.After 90 days, 10 patients had a good prognosis (mRs ≤ 2) and 1 patient died (pulmonary infection). Conclusion After mechanical thrombectomy of acute cerebral infarction, if there is severe stenosis or forward blood flow can not be maintained, use the Solitaire stent or other stent to remedy the placement, with fewer complications and better clinical effect. Key words: Acute ischemic stroke; Stent implantation; Remedial treatment; Mechanical thrombectomy","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43314433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.010
Wenhua Lin, C. Di, P. Gao, Qun Wang
Objective To explore the mechanism of the alternation of RR interval length in atrioventricular reentrant tachycardia (AVRT). Methods From August 2009 to August 2016, 317 patients with AVRT were treated by radiofrequency catheter ablation in cardiology department of TEDA International Cardiovascular Hospital were analyzed retrospectively.During AVRT, 5 mg of verapamil was given slowly intravenously for 10 min.After administration, the changes of RR interval, AH interval, HV interval and VA interval were observed and the time of changes was also observed. Results After administration of verapamil, there were 8 patients with RR interval alternation and QRS wave alternation.When RR interval alternation occurred, the difference of AH interval between adjacent heart beats was gradually extended, without AH jump, and the HV interval and VA interval were constant.This phenomenon occurred 6-17 minutes after administration, and the average cycle of tachycardia was 16-42 ms longer than before administration.In 3 patients, RR interval alternation occurred.When the phenomenon disappeared, the difference of AH interval between adjacent heart beats was gradually shortened, there was no AH jump, and the interval between HV and VA was constant until AH interval was equal, the disappearance time was 19-57 min after administration; AVRT was terminated in 5 patients after administration. Conclusion It can be concluded that the mechanism is due to the frequency dependent decreasing conduction of AH interval in tachycardia, which can not be induced by program stimulation. Key words: Verapamil; Atrioventricular reciprocating tachycardia; Electrophysiology; Catheter ablation; RR interval alternative
{"title":"Study on the mechanism of atrioventricular reentrant tachycardia with RR interval alternation","authors":"Wenhua Lin, C. Di, P. Gao, Qun Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.010","url":null,"abstract":"Objective \u0000To explore the mechanism of the alternation of RR interval length in atrioventricular reentrant tachycardia (AVRT). \u0000 \u0000 \u0000Methods \u0000From August 2009 to August 2016, 317 patients with AVRT were treated by radiofrequency catheter ablation in cardiology department of TEDA International Cardiovascular Hospital were analyzed retrospectively.During AVRT, 5 mg of verapamil was given slowly intravenously for 10 min.After administration, the changes of RR interval, AH interval, HV interval and VA interval were observed and the time of changes was also observed. \u0000 \u0000 \u0000Results \u0000After administration of verapamil, there were 8 patients with RR interval alternation and QRS wave alternation.When RR interval alternation occurred, the difference of AH interval between adjacent heart beats was gradually extended, without AH jump, and the HV interval and VA interval were constant.This phenomenon occurred 6-17 minutes after administration, and the average cycle of tachycardia was 16-42 ms longer than before administration.In 3 patients, RR interval alternation occurred.When the phenomenon disappeared, the difference of AH interval between adjacent heart beats was gradually shortened, there was no AH jump, and the interval between HV and VA was constant until AH interval was equal, the disappearance time was 19-57 min after administration; AVRT was terminated in 5 patients after administration. \u0000 \u0000 \u0000Conclusion \u0000It can be concluded that the mechanism is due to the frequency dependent decreasing conduction of AH interval in tachycardia, which can not be induced by program stimulation. \u0000 \u0000 \u0000Key words: \u0000Verapamil; Atrioventricular reciprocating tachycardia; Electrophysiology; Catheter ablation; RR interval alternative","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45251640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.005
Exian Mu, Purong Zhang, Jianhui Zhang, Shiwei Liu, Li Xia
Objective To compare the advantages of nano carbon suspension mapping method and non dye method in the number of axillary lymph nodes detected during axillary lymph node dissection and axillary micro lymph nodes detected after neoadjuvant chemotherapy for breast cancer. Methods From January 1st, 2018 to July 1st, 2018, 66 breast cancer patients who were to undergo axillary lymph node dissection after new adjuvant treatment were selected for the prospective study.Using the method of random number table, the patients were randomly divided into two groups: the group of nano carbon mapping (33 cases) and the control group (33 cases). After 24 hours subcutaneous injection of nano carbon before operation, axillary lymph node dissection and direct axillary lymph node dissection without dye were used.The number of axillary lymph nodes and the number of micro axillary lymph nodes in the two groups were observed. Results The number of axillary lymph nodes and micro lymph nodes in the nano carbon mapping group were higher than those in the control group.The differences were statistically significant (the number of axillary lymph nodes were (19.3±6.2) vs (14.9±6.7), P=0.007; the number of micro-lymph nodes were 2.0(0.5, 3.0) vs 0(0, 1.0), Z=-4.328, P<0.001). Conclusion Nano carbon suspension mapping can increase the number of lymph nodes detected in axillary lymph node dissection after neoadjuvant chemotherapy for breast cancer, and also has advantages in the detection of some small axillary lymph nodes that are not easy to find. Key words: Breast cancer; Carbon nanoparticle suspension; Axillary lymph node dissection; Micro-lymph nodes; Neoadjuvant chemotherapy
{"title":"The clinical advantage of nano carbon suspension mapping in the number of axillary lymph nodes detected after neoadjuvant chemotherapy for breast cancer","authors":"Exian Mu, Purong Zhang, Jianhui Zhang, Shiwei Liu, Li Xia","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.005","url":null,"abstract":"Objective \u0000To compare the advantages of nano carbon suspension mapping method and non dye method in the number of axillary lymph nodes detected during axillary lymph node dissection and axillary micro lymph nodes detected after neoadjuvant chemotherapy for breast cancer. \u0000 \u0000 \u0000Methods \u0000From January 1st, 2018 to July 1st, 2018, 66 breast cancer patients who were to undergo axillary lymph node dissection after new adjuvant treatment were selected for the prospective study.Using the method of random number table, the patients were randomly divided into two groups: the group of nano carbon mapping (33 cases) and the control group (33 cases). After 24 hours subcutaneous injection of nano carbon before operation, axillary lymph node dissection and direct axillary lymph node dissection without dye were used.The number of axillary lymph nodes and the number of micro axillary lymph nodes in the two groups were observed. \u0000 \u0000 \u0000Results \u0000The number of axillary lymph nodes and micro lymph nodes in the nano carbon mapping group were higher than those in the control group.The differences were statistically significant (the number of axillary lymph nodes were (19.3±6.2) vs (14.9±6.7), P=0.007; the number of micro-lymph nodes were 2.0(0.5, 3.0) vs 0(0, 1.0), Z=-4.328, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000Nano carbon suspension mapping can increase the number of lymph nodes detected in axillary lymph node dissection after neoadjuvant chemotherapy for breast cancer, and also has advantages in the detection of some small axillary lymph nodes that are not easy to find. \u0000 \u0000 \u0000Key words: \u0000Breast cancer; Carbon nanoparticle suspension; Axillary lymph node dissection; Micro-lymph nodes; Neoadjuvant chemotherapy","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42153387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.019
Zhanxiu Zhang
Coronary angiography is the core technology in the diagnosis and treatment of coronary heart disease. The left main coronary artery (LMCA), which supplies most of the left ventricular myocardium, is the key segment of the coronary network, but because of its special anatomical characteristics, it limits the value of coronary angiography in the diagnosis. Intravascular ultrasound, as an invasive tomographic technique, has been widely used in clinic to assist coronary angiography, and its value in diagnosis and treatment of left main artery disease has been recognized by most studies. Key words: Left main artery; Intravascular ultrasound; Percutaneous coronary intervention
{"title":"Research progress of intravascular ultrasound in diagnosis and treatment of left main artery disease","authors":"Zhanxiu Zhang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.019","url":null,"abstract":"Coronary angiography is the core technology in the diagnosis and treatment of coronary heart disease. The left main coronary artery (LMCA), which supplies most of the left ventricular myocardium, is the key segment of the coronary network, but because of its special anatomical characteristics, it limits the value of coronary angiography in the diagnosis. Intravascular ultrasound, as an invasive tomographic technique, has been widely used in clinic to assist coronary angiography, and its value in diagnosis and treatment of left main artery disease has been recognized by most studies. \u0000 \u0000 \u0000Key words: \u0000Left main artery; Intravascular ultrasound; Percutaneous coronary intervention","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49371046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.02.009
Guobin Zhao, Xin Liu, Yu-hong Tang, H. Su, Lidong Tang, C. Feng, Chaoyang Li, Yu Wang, Haibin Ling
Objective To investigate the application of 3D printing technique in percutaneous nephrolithotomy (PCNL) of patients with complicated kidney stones. Methods From January 2015 to December 2017, 60 patients with complicated kidney stones were enrolled in the First Affiliated Hospital of Hebei North University for prospective study, and PCNL was proposed.All the patients were randomly divided into 3D print group (30 cases) and conventional image inspection group (30 cases, control group). Before operation, CT urography (CTU) was used in both groups.In 3D printing group, digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image postprocessing, and thermoplastic materials were used to print 3D model.In the 3D printing group, the digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image post-processing, and the 3D model was printed with thermoplastic materials.According to the comprehensive planning of 3D kidney model, a virtual safe and reliable percutaneous renal access was established for each patient, and PCNL was executed.The patients in the two groups were compared before, during and after operation.Preoperative: age, sex, body mass index, blood creatinine, stone size and CT value.During the operation: (1) the target renal calices location time; (2) the conformity between the preoperative planning and the actual operation; (3) the operation completion time.After operation: (1) stone removal rate; (2) hemoglobin reduction level; (3) postoperative recovery. Results All the 60 patients successfully completed the operation, 30 patients successfully printed out the 3D model, which can accurately express the relationship between the stone and the adjacent anatomical structure, the internal renal artery and the collecting system.Positioning time of 3D printing group in target renal calices((2.9 ± 1.5) min vs.(5.8 ± 1.7) min, P=0.023), coincidence between simulated and actual puncture calices((89.5 ± 3.5)% vs.(60.2 ± 5.7)%, P=0.005), postoperative stone removal rate ((89.9 ± 4.5)% vs.(75.9 ± 5.2)%, P=0.009), and hemoglobin levels((1.4 ± 0.5) g/L vs.(2.9 ± 1.4) g/L, P=0.032) were superior to the control group, and the difference was statistically significant.But there was no significant difference between the two groups (all P>0.05). Conclusion The 3D printed kidney model truly restores the anatomical details around the kidneys and stones, providing a stereoscopic and intuitive way to perform surgery, so it maybe has a significance guidance for percutaneous nephrolithotomy. Key words: Kidney stones; Percutaneous nephrolithotomy; Kidney model; Surgery simulation
{"title":"Application of 3D printing technique in percutaneous nephrolithotomy of patients with complicated kidney stones","authors":"Guobin Zhao, Xin Liu, Yu-hong Tang, H. Su, Lidong Tang, C. Feng, Chaoyang Li, Yu Wang, Haibin Ling","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.02.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.02.009","url":null,"abstract":"Objective \u0000To investigate the application of 3D printing technique in percutaneous nephrolithotomy (PCNL) of patients with complicated kidney stones. \u0000 \u0000 \u0000Methods \u0000From January 2015 to December 2017, 60 patients with complicated kidney stones were enrolled in the First Affiliated Hospital of Hebei North University for prospective study, and PCNL was proposed.All the patients were randomly divided into 3D print group (30 cases) and conventional image inspection group (30 cases, control group). Before operation, CT urography (CTU) was used in both groups.In 3D printing group, digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image postprocessing, and thermoplastic materials were used to print 3D model.In the 3D printing group, the digital imaging and communications in medicine (DICOM) files of CT were extracted for 3D image post-processing, and the 3D model was printed with thermoplastic materials.According to the comprehensive planning of 3D kidney model, a virtual safe and reliable percutaneous renal access was established for each patient, and PCNL was executed.The patients in the two groups were compared before, during and after operation.Preoperative: age, sex, body mass index, blood creatinine, stone size and CT value.During the operation: (1) the target renal calices location time; (2) the conformity between the preoperative planning and the actual operation; (3) the operation completion time.After operation: (1) stone removal rate; (2) hemoglobin reduction level; (3) postoperative recovery. \u0000 \u0000 \u0000Results \u0000All the 60 patients successfully completed the operation, 30 patients successfully printed out the 3D model, which can accurately express the relationship between the stone and the adjacent anatomical structure, the internal renal artery and the collecting system.Positioning time of 3D printing group in target renal calices((2.9 ± 1.5) min vs.(5.8 ± 1.7) min, P=0.023), coincidence between simulated and actual puncture calices((89.5 ± 3.5)% vs.(60.2 ± 5.7)%, P=0.005), postoperative stone removal rate ((89.9 ± 4.5)% vs.(75.9 ± 5.2)%, P=0.009), and hemoglobin levels((1.4 ± 0.5) g/L vs.(2.9 ± 1.4) g/L, P=0.032) were superior to the control group, and the difference was statistically significant.But there was no significant difference between the two groups (all P>0.05). \u0000 \u0000 \u0000Conclusion \u0000The 3D printed kidney model truly restores the anatomical details around the kidneys and stones, providing a stereoscopic and intuitive way to perform surgery, so it maybe has a significance guidance for percutaneous nephrolithotomy. \u0000 \u0000 \u0000Key words: \u0000Kidney stones; Percutaneous nephrolithotomy; Kidney model; Surgery simulation","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44079644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：